A Case of Superwarfarin Poisoning Due to Repetitive Occupational Dermal Rodenticide Exposure in a Worker

Superwarfarin poisoning is usually due to chronic occult small-dose exposures and can easily be misdiagnosed and may lead to serious complications. The diagnosis can be confirmed by a concordant history and analyses of blood and urine specimens with the liquid chromatography with tandem mass spectrometry (LC-MS/MS) technique. Several months of continuous treatment with high doses of daily oral vitamin K, as well as other supportive measures, are warranted, especially when repeated laboratory measurements to help predict the treatment period are not available. In this paper, a case of superwarfarin poisoning due to chronic repetitive occupational dermal exposure to commercial rodenticides is presented.